Jackson, Kevin Wade

Jackson, Kevin Wade is an sole proprietor health care provider with primary practice located at 18511 Highlander Medics St , Fort Bliss TX 79906-5327. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Jackson, Kevin Wade can be contacted via phone (915) 742-7777.

Contact Information

Primary practice address
18511 Highlander Medics St Fort Bliss TX 79906-5327
Phone: (915) 742-7777
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X V1796 Texas

Profile Details

NPI number 1770103624
LBN Legal business name Jackson, Kevin Wade
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 21st, 2020
Last updated Jun 27th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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